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Doctors other than Pods.

Posted by Matt P on 5/21/05 at 16:13 (175435)

This is the second of three posts. I'm sorry if that's overdoing it, but I didn't feel like I should post all three topics in one message.

I have had really horrible luck with podiatrists I can access through insurance; I think this is because my problem is beyond their scope (they seem to be stumped when I'm not cured by their prescribed regimen of icing, stretching, orthoticcs, medication, and rest.) I want to look into other doctors that may have something to say. What types of doctors should I visit? I would reallly look into the impact of diet and nutrition on the health of my tendons, joints, etc. Also, I want to look at the possibility that my feet are not receiving adequate blood flow to promote healing. Last, I would like to speak with someone who can address the very structure of my legs as sometimes I feel like they are simply aligned poorly.

If it seems as though I've answered my own questions, I simply need to know the names of the type of doctor that can answer questions in these areas. Thank you so much!

Re: Doctors other than Pods.

Ron on 5/22/05 at 15:19 (175478)

First, what's your problem? From the description of treatments I'm guessing it's Plantar Fasciitis (PF), or as they call heel spurs. An exact description of your symptoms regardless of diagnosis can help as well.

> I have had really horrible luck with podiatrists I can access through
> insurance; I think this is because my problem is beyond their scope
> (they seem to be stumped when I'm not cured by their prescribed regimen
> of icing, stretching, orthoticcs, medication, and rest.)

I think most doctors don't understand how to treat PF conservatively, other than these methods. As for me, my PF has lasted for years with only being prescribed stretching. I stretched my brains out until I thought there must be something else wrong. However, not knowing how to stretch was my main problem.

There is more to stretching than just holding the same position for 10 seconds or longer and eventually your body will respond or learn what you want it to do. The stretch that has been working for me is Active-Isolated Stretches, but there are also other stretching techniques out there that might work equally as well, or even better.

> I want to look into other doctors that may have something to say. What
> types of doctors should I visit? I would reallly look into the impact of
> diet and nutrition on the health of my tendons, joints, etc.

There is no doubt that nutrition has an impact on every part of your health, including our tendons and joints. Whatever you do, don't go too far too fast with any treatment(s). Avoiding extremes is important for any successful health routine. After all, there is nothing more unnatural than expedient change.

> Also, I
> want to look at the possibility that my feet are not receiving adequate
> blood flow to promote healing.

Many therapies have proposed this blood flow theory of healing for such conditions as PF. The question is how to get there, and which way can promote more blood flow consistently. Massage seems like a great choice in this area, but treatments may have to be permanent, and what I've read they are.

Speaking logically about this, if there is a biomechanical reason for your particular problems in your lower extremeties, then it's only logical that certain treatments have almost no chance of success. On the assumption that your problem is biomechanical in nature then only the correction of the biomechanics is your only hope. That would include some type of physical therapy.

For me at least the theory above has held true. Stretching has helped me quite a bit, but only when I found out how to stretch correctly.

Ever since I started AIS (Active-Isolated Stretching) I've had limited pain in my feet, as if it's almost a miracle. Am I more flexible? Yes, but not enough to account for how well I've healed in only a short time. The only answer left to me is more oxygen and energy to the area in the form of blood.

>Last, I would like to speak with someone
> who can address the very structure of my legs as sometimes I feel like
> they are simply aligned poorly.

I think a kiniseologist would do just fine. Here's a thread I found with a little more information on a kiniseologist recommending an ART practitioner:
http://www.coolrunning.com/forums/Forum11/HTML/005639.shtml

The problem isn't always who or what, it's how much effort is put to your problem. A professional athlete may have the best of the best with 10 trainers at his beck-and-call 24/7. It's no wonder many get back on track miracuously.

Most doctors spend 10 minutes with you once a month and can't understand why you aren't healing properly. What I'm suggesting is much of the work is going to have to be done by you in researching your disease. That might even entail knowing more about your particular problem than your doctor. It's a lot of work but not as much as running around in circles through the expert circuit.

Good luck!

Re: Doctors other than Pods.

Tina H on 5/22/05 at 18:49 (175502)

Ron, Thanks for taking the time to leave this interesting post. I'm sure many will find food for thought. Tina

Re: Doctors other than Pods.

Terri on 5/23/05 at 13:11 (175548)

I know what you mean about doctor's being stumped. I have really bad PF and have gotten the most helpful info from the person that made my orthotics ( he told me I had some of the highest arches he had ever seen - a major cause of PF ). My PF has improved slightly from giving up exerise, and sitting almost all the time. I was very active until I could hardly walk. I went pods, orthopeadics and a primary care doctor. None of them have been able to help me so far. The orthopeadics were the least helpful.

Re: Thank you Ron...

Matt P on 5/23/05 at 17:21 (175562)

That was a most helpful message... thanks for taking the time. I'm going to look into AIS

Re: Thank you Ron...

Ron on 5/23/05 at 18:43 (175566)

Just remember that not everything works for everybody. Give it at least a few weeks to a month to see if AIS is beneficial. The most important thing is to get a book by Aaron Mattes, the originator of AIS, and Phil Wharton, one of his students. The techniques aren't as simple as you might think, but once the underlying theory is understood you'll see why other techniques aren't as effective.

I've found out that you really need a picture in order to do these properly. And the more you know about your physiology the better results you can get. At Boston College the athletes 'receive extensive and specific instruction for each' AIS stretch. http://www.momentummedia.com/articles/tc/tc1503/stretchfield.htm

Here are some other links that might interest you:
http://www.stretchingusa.com/
http://www.aistretch.com/exercises.htm
http://www.aistretch.com/
http://www.hartmann-international.com/001articles/stretching.htm
http://www.massageandbodywork.com/Articles/AugSept2000/stretching.html
http://www.ackerman-massage.com/ais.htm
http://www.mrtherapy.com/articles/article2.html

What I'm really curious is if someone can have success with this other than myself. I'm still not totally convinced this alone will cure my PF. If you're going to try AIS, then please tell me how it goes.

Re: Doctors other than Pods.

Ed Davis, DPM on 5/23/05 at 22:20 (175576)

Matt:
You are mentioning about 1/5 of the podiatry regimen for plantar fasciitis so how can you say that such treatment is beyond their scope?
Now you added the key words 'podiatrists I can access through my insurance.'

Is it possible that your insurance is so limited that only the 'bottom of the barrel' of the profession will sign up?

Podiatrists have the expertise. Read Scott's heel pain book to find out the complete treatment regimen for plantar fasciitis.

Sometimes you just need to break free from you insurance plan if they have no quality practitioners signed up or if your insurance is tying their hands as so many insurnace companies do.
Ed

Re: Doctors other than Pods.

lara on 5/24/05 at 08:08 (175610)

My feet were not responding to treatment for 3 years (with podiatrists, orthoepedic surgeons & physical therapists) - until I happened upon a doctor that knew Tarsal Tunnel Syndrome. One of the orthopedic surgeons even suggested a diagnosis that demonstrated a misunderstanding of neuropathy & diabetes. This isn't a knock on the training and competence of orthodic surgeons in general, just this doctor.

If I wanted to increase my chance of success of finding a doctor to diagnose and treat successfully, I'd try to find a doctor (o.s. or podiatrist) who does significant work with sports medicine.

Re: Doctors other than Pods.

Matt P on 5/28/05 at 10:29 (175837)

Dr. Ed: You area almost certainly correct here, and it was not my intention to malign the profession, only to describe my experience with four separate podiatrists who have helped me very, very little. The intention of my message was to seek help as I consider other specialties that may be worth consulting. Your response is valuable in it's instruction to look beyond my insurance company. I could use some advice on that one, though. Hopefully I didn't post response too late.